Swine flu

The new strain of influenza A (H1N1) was first reported from Mexico this year (2009). The spectrum of disease caused by new influenza A (H1N1) virus infection ranges from non-febrile, mild upper-respiratory tract illness to severe or fatal pneumonia. Most cases appear to have uncomplicated, typical influenza-like illness and recover spontaneously.

Most commonly reported symptoms include:
1. cough
2. fever
3. sore throat
4. malaise
5. headache

“Rapidly progressive respiratory disease has accounted for most severe or fatal cases”
From the Chinese medicine viewpoint, this is due to transmission of external pathogenic factor from the Wei Level to the Qi Level with the pattern of Lung-Heat and then eventually to the Ying and Blood Level.

An influenza epidemic or pandemic is a typical Wen Bing disease. This is because it is very virulent and has a strong tendency to enter the Qi level (causing chest infections) very quickly.

Wei Level
The main symptoms of invasion of Wind-Heat are aversion to cold, shivering, fever, sore throat, swollen tonsils, headache and body-aches, sneezing, cough, runny nose with yellow discharge, slightly dark urine, slightly Red sides of the tongue and a Floating-Rapid pulse. It is worth noting that in Wind-Heat too there is aversion to cold as this is due to Wind-Heat obstructing the Wei Qi which therefore fails to warm the muscles. This corresponds to the beginning stages of influenza when the patient has “aversion to cold”.
With our treatment, we should always aim at expelling the Wind at the Wei Level: even though this may not be entirely possible, it will make the symptoms of the Qi Level milder and it will prevent complications.

Qi Level
At the Qi Level-Heat. Wind penetrates into the Interior and it changes into interior Heat or Phlegm-Heat. With influenza, this usually manifests with bronchitis or pneumonia. The Qi Level is a crucial level as the pathogenic factor can be expelled completely or it can get worse by penetrating further into the Interior at the Ying or Blood level.
The Qi Level symptoms are symptoms of Interior Full Heat: high fever, thirst, sweating, feeling of heat, red face.
At the Qi Level-Fire, the tongue is Red with a thick-yellow coating and the pulse is Full and Rapid. As long as there is a coating, the patient is still at the Qi Level. When the coating falls off, the patient is at the Ying or Blood level.


Ying/Blood Level
At the Ying and/or Blood Level, Heat has injured Yin so that the tongue has no coating (and it is Red). The Ying or Blood Levels are always dangerous because it may lead to mortality. Internal Wind may develop at the Blood Level and convulsion in children during febrile diseases always indicate the presence of internal Wind at the Blood Level.
The symptoms of the Ying Level are fever at night, mental confusion, delirium, cold hands, Red tongue without coating. The symptoms of the Blood Level are fever at night, possibly convulsions, maculae, bleeding, Red tongue without coating.

TREATMENT WITH THREE TREASURES REMEDIES
EXPEL WIND-HEAT
Invasions of Wind-Heat manifest with aversion to cold, fever, thirst, sore throat, body aches, headache, tonsillitis, ear infection, cough, Floating-Rapid pulse and tongue red on the sides. This is the remedy for Wei Level. The dosage is at least 9 tablets a day. This is the remedy of choice for influenza: use 12 tablets a day. Expel Wind-Heat should be a stand-by remedy in any household with children.
Please note that this remedy is used only in the beginning stages when the external Wind is still on the Exterior: at this time, the patient will have “aversion to cold” as described above.

CLEAR METAL
Clear Metal was formulated to treat the Qi Level of influenza. The simplest and clearest sign that the invasion of Wind has moved from the Exterior (Wei Level) to the Interior (Qi Level) is that the patient feels no longer cold and does not shiver but feels instead hot and thirsty. The most common patterns at this level are either Lung-Heat of Lung-Phlegm-Heat so that the patient develops bronchitis or pneumonia.
Clear Metal was formulated to treat primarily Lung-Heat at the Qi Level when the patient displays the following symptoms: cough, slight breathlessness, fever, feeling of heat, thirst, tightness of the chest and upper back. Clear Metal has also a strong anti-viral action.
The dosage for an adult is at least 9 tablets per day. This dose can be exceeded in severe cases.

RINGING METAL
Ringing Metal, a variation of Qing Qi Hua Tan Tang Clearing Qi and Resolving Phlegm Decoction can be used for acute chest infections following an invasion of Wind, i.e. when the pathogenic factor is Phlegm-Heat in the Lungs at the Qi level. The main manifestations calling for this remedy in this context are: a cough following a cold or flu, expectoration of profuse sticky-yellow sputum, slight breathlessness, a feeling of oppression of the chest, possibly fever, thirst, disturbed sleep, a Full-Slippery pulse, a red tongue with sticky-yellow coating. The dosage is at least 9 tablets per day.

HERBAL SENTINEL
Herbal Sentinel is the remedy to take for prevention. It strengthens immunity and resistance to viruses and bacteria by tonifying Lung- and Kidney-Qi. It is to be taken continuously as long as the swine flu epidemic continues in dosages of 4 tablets a day (for an adult).
There are two Herbal Sentinel remedies: Herbal Sentinel - Yang and Herbal Sentinel - Yin. The former is for people with a tendency to Yang deficiency (with a Pale tongue); the latter for people with a tendency to Yin deficiency (with a tongue lacking in coating completely or partially).

My favourite point: G.B.-13 Benshen Spirit Root

a) Nature
Point of the Yang Linking Vessel (Yang Wei Mai).
Meeting point of the 3 Yang Muscle channels of the arm.

b) Actions
- Calms the Mind (Shen) and settles the Ethereal Soul (Hin)
- Subdues Liver-Yang
- Extinguishes Wind
- Resolves Phlegm
- Gathers Essence (Jing) to the head
- Clears the brain.

c) Indications
Manic behaviour, fright
Headache, dizziness
Epilepsy, hemiplegia, convulsions
Vomiting of foamy saliva, epilepsy with foaming at the mouth.

d) Comments
G.B.-13 is a very important point for mental and emotional problems. It is very much used in psychiatric practice for schizophrenia and split personality combined with HE-5 Tongli and G.B.-38 Yangfu.1 It is also indicated when the person has persistent and unreasonable feelings of jealousy and suspicion.
Apart from these mental traits, it has a powerful effect in calming the Mind, settling the Ethereal Soul (Hun) and relieving anxiety deriving from constant worry and fixed thoughts. Its effect is enhanced if it is combined with Du-24 Shenting.
Its deep mental and emotional effect is also due to its action of “gathering” Essence (Jing) to the head. The Kidney-Essence is the root of our Pre-Heaven Qi and is the foundation for our mental and emotional life. A strong Essence is the fundamental prerequisite for a clear Mind (Shen) and a balanced emotional life. This is the meaning of this point's name “Root of the Spirit”, i.e. this point gathers the Essence which is the root of the Mind (Shen) and Spirit. The Kidney-Essence is the source of Marrow which fills up the Brain (called Sea of Marrow): G.B.-13 is a point where Essence and Marrow “gather”. The “Great Dictionary of Acupuncture” says that this point “makes the Mind [Shen] return to its root”2: the “root” of the Mind is the Essence, hence this point “gathers” the Essence to the Brain and affects the Mind. As it connects the Mind and the Essence, it also treats both the Heart and the Kidneys and therefore the Mind (Shen) and Will-Power (Zhi): for this reason, it is an important point in the treatment of depression.
When combined with other points to nourish Essence (such as Ren-4 Guangyuan), G.B.-13 attracts Essence towards the head with the effect of calming the Mind and strengthening clarity of mind, memory and will power. The connection between G.B.-13 and the Essence is confirmed by the text “An Enquiry into Chinese Acupuncture” which has among the indications of this point: “excessive menstrual bleeding, impotence and seminal emissions.”3
G.B.-13 also subdues Liver-Yang and it can therefore be used as a local point in chronic headaches from Liver-Yang rising. It also extinguishes internal Wind and is effective for Wind-stroke and epilepsy. Finally, it resolves Phlegm in the context of mental-emotional disorders or epilepsy, i.e. it opens the Mind's orifices when these are clouded by Phlegm. The “Explanation of the Acupuncture Points” says: “The indications of G.B.-13 show that it eliminates the three pathogenic factors of Wind, Fire and Phlegm from the Lesser Yang, in which cases this point should be reduced.”4

1. Dr Zhang Ming Jiu, personal communication, Nanjing 1982.
2. Cheng Bao Shu 1988 Great Dictionary of Acupuncture (Zhen Jiu Da Ci Dian), Beijing Science Publishing House, Beijing, p. 11.
3. Jiao Shun Fa 1987 An Enquiry into Chinese Acupuncture (Zhong Guo Zhen Jiu Qiu Zhen), Shanxi Science Publishing House, p. 52.
4. Yue Han Zhen 1990 An Explanation of the Acupuncture Points (Jing Xue Jie), People's Health Publishing House, Beijing. Originally published in 1654, p. 334.

Stomach crack on the tongue

The Stomach crack on the tongue is rather wide and it is in the central section of the tongue (corresponding to Middle Burner). To contrast and compare the Heart and Stomach cracks, the former is rather narrow and runs all along the tongue from near the root to near the tip, while the latter is rather wide and is only in the middle of the tongue. Please see previous posts to see pictures of a Heart crack.
A Stomach crack indicates the tendency to Stomach-Yin deficiency. People with such a crack often have no digestive symptoms but I always recommend treating it by using Ren-12, ST-36 and SP-6.

CHEMO-SUPPORT VETERINARY USE

The following is a case history on the use of Chemo-Support to counteract the side effects of chemotherapy in a cat. This was sent to me by an American vet.

The case is a cat with lymphoma. An ultrasound revealed nodules in her spleen on 29 November 2007. She had previously had a pancreatic cyst removed surgically. She was given acupuncture and started on Chemo-Support 6 December 2007. She received chemotherapy for her lymphoma twice in Dec 07, but got very ill from it so the owner declined any further injectable chemotherapy. Prednisone and leukeran were started, but she developed diabetes as a result of the prednisone. Her prednisone was reduced and she was started on insulin. I started her on shen ling bai zhu san and a formula to nourish the kidney essence. She has gone through periods of severe anemia (15-17%) that we have managed it with Bvits/iron, homeopathics, managing her prednisone dose, and increasing her Chemo-Support. Although she is receiving a number of supplements and meds, it has seemed that increasing the amount of Chemo-Support was significantly helpful for her.

I have used the formula Chemo-Support in other cat patients with cancer, if they are receiving chemo, or if they need a good blood, qi, spleen tonic with immune modulating effects.

As an aside, I have also found the formula Chemo-Support helpful in immune-mediated disease. In particular I remember the case of a dog with severe immune-mediated arthritis that stabilized once Chemo-Support was started.

My favourite herbal formula - Gan Mai Da Zao Tang

Gan Mai Da Zao Tang Glycyrrhiza-Triticum-Jujuba Decoction is first mentioned in the Jin Gui Yao Lue by Zhang Zhong Jing (220 AD). It is in chapter 22 “Pulses and Patterns of Complicated Women’s Diseases”. Zhang Zhong Jing says “Women suffering from anxiety are affected by sadness and crying, they are like lost souls [shen ling] and yawn frequently: use Gan Mai Da Zao Tang.”
I use this formula for depression and anxiety occurring against a background of deficiency (which may be of Qi or Blood). I call this one of the “magic” formulae because the very simple ingredients do not explain the profound effect of this formula. In fact, the ingredients (only three) are mild foods: licorice, wheat husks and dates.
Since this formula has only three ingredients, I sometimes add it to another formula I am using. Gan Mai Da Zao Tang is available in the Three Treasures as Soothe the Shen.

Clinical Tip of the Day no. 3

A red tip of the tongue is very common. The tip corresponds to the Heart and the Shen and a redness of the tip always indicates emotional stress affecting the Heart: the redder the tip, the more intense the stress. Why is the tip affected and why does it become red? The Heart is affected by all emotions as it houses the Shen that feels them. When we feel angry, anger affects the Liver automatically, but it is the Shen of the Heart that “feels” the anger. Thus, a red tip of the tongue may be caused by any of the emotions, e.g. anger, sadness, grief, worry, fear, etc.

Why does the tip become red? The first effect of emotional stress is some Qi stagnation: when Qi stagnates, it frequently gives rise to Heat and hence the redness of the tip. If, besides being red, the tip is also swollen and has red points, it indicates that the emotional stress is even greater.

My favourite points - no. 2

LU-3 Tianfu (3 cun below axillary fold)
Window of Heaven point. These points regulate the ascending and descending of Qi from the body to and from the head: they do so in the crucial neck area. Therefore, they can both subdue rebellious Qi and promote the ascending of clear Qi to the head.

On a psychic level, LU-3 action in regulating the ascending and descending of Qi to and from the head has a mental-emotional effect. For example, insomnia is due to Qi ascending too much to the head (or not descending from it) while somnolence and forgetfulness are due to clear Qi not ascending to the head. The “Explanation of the Acupuncture Points” (1642) says that LU-3 can make Qi rise to treat forgetfulness, sadness and weeping due to Qi not rising to head. Forgetfulness is an important indication for this point: this is forgetfulness due to clear Qi not rising to the head. According to the “Explanation of the Acupuncture Points”, this point treats forgetfulness by stimulating the ascending of Qi of both Lungs and Heart.

The mention of weeping in this ancient text is interesting. It means that this point treats afflictions of the Lungs from sadness and grief leading to weeping.

Finally, “talking to ghosts” features heavily in this point's indications. Generally speaking, when ancient books mention such symptoms as talking or seeing ghosts among the indications of a point, it means that the point is indicated for relatively serious mental-emotional problems and, in particular, when the Mind is obstructed. Obstruction of the Mind can potentially cause serious mental problems such as manic-depression or psychosis. Again, this point can open the Mind's orifices, i.e. de-obstruct the Mind by regulating the ascending and descending of Qi to and from the head: it opens the Mind's orifices by promoting the descending of turbid Qi from the head and the ascending of clear Qi to the head (which, as we have seen above, is a general function of the Window of Heaven points).